Dementia and the take-up of residential respite care: an analysis using the PIAC cohort

In the current policy and service environment, respite care is a key service designed to provide support for carers and those they care for. Linked aged care program data for the Pathways in Aged Care (PIAC) cohort study allows analysis of the take-up of residential respite care by looking at 32,000 cohort members who had an approval of such care. This report presents detailed analysis of take-up rates and factors that affect the take-up of residential care. In particular the report investigates whether dementia, carer availability and English speaking background affect the take-up of residential care.

Summary

Caregivers regularly identify respite as their most urgent care need, and the provision of respite care has developed in response to this. Current evidence about respite use patterns for people with dementia and their carers is largely based on small-scale studies and qualitative research. This report assesses the take-up of residential respite care (RRC) following an Aged Care Assessment Team (ACAT) approval for people with and without dementia. It analyses data from the Pathways in Aged Care (PIAC) project which uses record linkage to identify use of aged care programs following an assessment by an ACAT. It focuses on the take-up of RRC by 32,000 people who were living in the community and had a relevant ACAT approval in the 2003-04 financial year.

Take-up of residential respite care

Only about a quarter (27%) of people approved for RRC actually used it within 12 months of their approval. This was true for both those recommended to live in the community and those recommended to live in residential care.

Dementia

A somewhat greater proportion of people with dementia took up RRC (32%) than those without dementia (25%). Statistical modelling showed that people with dementia were more likely than others to take up RRC even when controlling for a range of other factors.

Carer status

Having a carer increased the likelihood of a client taking up RRC. Among those recommended to live in the community, people with a carer were more likely to take up RRC (29%) than those who did not have a carer (21%). A similar pattern was observed for those recommended to live in residential care. This carer effect was apparent even when taking other factors into account.

English proficiency

For people recommended to live in the community, those born in non-English-speaking countries had a lower take-up rate (24%) than those born in English-speaking countries (28%). However, for those recommended to live in residential care, there was no significant difference in take-up rate.

A number of other factors were associated with take-up of RRC. These varied according to whether people were recommended to be living in the community or in residential care.

Movement into permanent residential care after using respite care

Among people recommended to live in the community, statistical modelling showed there was an increased likelihood of admission into permanent residential care within 12 weeks of take-up of RRC if the person had dementia or no carer.